At the 2025 Revolutionizing Atopic Dermatitis (RAD) Conference in Nashville, Dr. Gil Yosipovitch highlighted new advances in understanding and treating chronic itch, focusing on atopic dermatitis (AD) and other skin conditions. As a professor of dermatology and director of the Miami Itch Center, Yosipovitch emphasized how inflammation and nerve signals interact in the skin, making AD an important model for studying itch.
Yosipovitch discussed a range of new biologic drugs and small molecules that target type 2 inflammation and neuroimmune pathways. These include IL-4, IL-13, and IL-31 blockers such as dupilumab, lebrikizumab, and nemolizumab. These treatments not only reduce inflammation but also directly ease itch. He also pointed to JAK inhibitors like abrocitinib and povorcitinib, which affect multiple itch-related cytokines.
The session also covered therapies aimed at neuropathic itch and chronic pruritus of unknown origin (CPUO), a condition often seen in older adults who suffer intense itch without visible rash. Yosipovitch noted that IL-targeted drugs like dupilumab and nemolizumab show promise for treating CPUO, based on clinical experience and ongoing trials.
From a neuropharmacology viewpoint, gabapentin and pregabalin, which affect GABA receptors, remain useful for neuropathic itch. New data support the use of kappa opioid receptor agonists such as difelikefalin and intranasal butorphanol for cases where traditional anti-inflammatory treatments fail.
Yosipovitch also called for more research into sodium channel blockers like Nav1.7 and Nav1.8, which might help control itch by acting on nerve signals. He stressed the need for a better understanding of how skin and brain communicate, especially when immune responses play a minor role.
Finally, Yosipovitch stated that while AD is a key example of inflammatory itch, the insights from RAD could improve treatment for many other skin diseases where chronic itch is a major problem. He urged continued research that combines immunology and neurobiology to develop more effective therapies in the future.
Related Topics:
